Clinical effect of percutaneous intraluminal radiofrequency ablation combined with biliary stenting and biliary stenting alone in the treatment of malignant obstructive jaundice / 军事医学

ABSTRACT

Objective To compare the effect of percutaneous intraluminal radiofrequency ablation ( RFA ) combined with biliary stenting and that of percutaneous transhepatic puncture combined with biliary stenting .Methods A total of 56 patients with unresectable malignant obstructive jaundice were reviewed retrospectively .Among them, 25 patients had received percutaneous intraluminal RFA combined with biliary stenting ( RFA group) while another 31 patients had been simultaneously selected for the simple biliary stent implantation ( stent group ) .The changes of the serum total bilirubin ( TB) and direct bilirubin ( DB) before and after 7-14 days of treatment , surgical complications , stent median patency and the median survival were observed.Follow-up information was obtained through telephone reviews or check-up records. Results The technical success rate was 100%.No procedure-related peritonitis or perforation occurred .There were respectively 3 cases with cholangeitis in RFA group and 3 in stent group.All the cases was controlled by effective clinical treatment.There was obvious statistically significant difference after treatment in TB and DB in the two groups (P<0.01, P<0.01).TB and DB fell by (149.05 ±110.71) and (96.93 ±69.12)μmol/L after 7-14 days in RFA group vs (151.40 ±94.47) and (94.21 ±67.36)μmol/L in stent group.The changes of the two groups were of no statistical significances .The stent patenmedian time was 122 ( 9 -550 ) and 157 ( 16 -510 ) d, while the median survival was 125(9-550) and 163 ( 16 -520 ) d.The difference was of no statistical significance .Conclusion Percutaneous intraluminal RFA combined with biliary stenting and percutaneous transhepatic puncture combined with biliary stenting are both safe and feasible therapeutic options for unresectable malignant obstructive jaundice .There is no statistically significant diffference between the two groups in the recent and long-term curative effects .